CMS Price Transparency Data

Psychological testing by technician

Facility: Charleston Area Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $35
Cash Discount Price: $94
vs. Medicare Baseline: 0.08x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Charleston Area Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.08x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $94 (21%)

Insurance Median: $35 (8%)

Cash: $94 (21% of Medicare)

Ins. Median: $35 (8% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Tricare	$22 - $91	5%
Aetna	$23 - $36	5%
The Health Plan Of West Virginia Inc.	$23 - $53	5%
Unicare Health Plan Of West Virginia Inc.	$23 - $26	5%
City Of Charleston	$27 - $43	6%
Blue Cross Blue Shield	$29 - $41	6%
Integrated Medical Solutions	$32 - $48	7%
Triwest Va	$32 - $35	7%
Choicecare Network	$33 - $38	7%
Cigna	$33 - $150	7%
Optimum Choice Inc.	$33 - $36	7%
UnitedHealthcare	$33 - $37	7%
Healthsmart	$35 - $149	8%
Multiplan	$35 - $149	8%
Three Rivers Providers Network	$35 - $147	8%
West Virginia Senior Advantage Inc.	$35 - $38	8%
Caresource	$36 - $49	8%
Naphcare	$36 - $45	8%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $94.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Charleston Area Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.